May cause osteoporosis when breastfeeding



Summary:
Introduction: Pregnancy and breastfeeding represent phases in the life of a woman with profound changes in metabolism. There are also profound changes in the bones and bone metabolism, which could play an important role in the density and quality of the bone in postmenopausal women. If the increased calcium requirement during pregnancy can still be largely covered by increased absorption, the hormonal changes during breastfeeding usually lead to a measurable reduction in bone mass, which has been proven with different methods. After the postpartum amenorrhea has ended, the results of the tests show, relatively consistently, a compensation for the loss of bone mass. In postmenopausal women, these processes in the sum could have both protective and deleterious effects on the bones and thus on the risk of developing postmenopausal osteoporosis. The data situation is inconsistent in this regard and shows some positive, some negative effects on bone density, osteoporosis or the risk of fractures. Overall, the influence of pregnancy and breastfeeding on the risk of osteoporosis and fracture in postmenopausal women appears to be small. Material and method: As part of our investigation into the influence of pregnancy and lactation on the measured values ​​of quantitative ultrasonometry (QUS), a total of 2,080 (age DS ± SD, 58.8 ± 8.2 years) postmenopausal women were included in a cross-sectional study. Basic anamnestic data as well as the ultrasound conduction speed (SOS), the broadband ultrasound attenuation (BUA) and the stiffness index (SI) at the calcaneus were analyzed. Women with diseases related to bone metabolism, osteoporosis with or without a history of fractures were excluded. A comparative matched-pair analysis was carried out according to the division into nulliparians, paris, women who had breastfed and women who had never breastfed and “matching” according to age, height, weight and BMI. In addition, a step-wise, linear, multiple regression analysis was performed. Results: Neither the comparison of the nulliparous and Para group nor the number of pregnancies showed a significant influence on the measurement results of the QUS in postmenopausal women. In a comparison of women who had breastfed with women who had never breastfed, neither the matched-pair analysis nor the step-by-step linear, multiple regression analysis showed a significant influence on the measurement results of the QUS. Discussion: These test results confirm for the first time that the bone metabolic changes measurable during pregnancy and breastfeeding in postmenopausal women have no significant influence on the measurement results of the quantitative ultrasonometry. Overall, the effect of breastfeeding on bone density and fracture risk in postmenopausal women appears to be minor and clinically insignificant. To what extent in individual cases with a summation of various risk factors then also through pregnancy or breastfeeding postmenopausal osteoporosis can be caused, but cannot be assessed with this. With regard to the complex processes on bones during pregnancy and breastfeeding and their effects, there are still many unanswered questions that require further prospective investigations.

Summary:
OBJECTIVE: Reproductive factors such as parity and breast-feeding may be associated with low bone mass and osteoporotic fractures in later years. In this study, os calcis quantitative ultrasonometry was used to elucidate the relationship between parity, lactation and bone mass in postmenopausal women. DESIGN: This was a comparison study using subsequent matched pairs analysis as well as multiple linear regression analysis. The study was carried out at five centers in Germany. The study included 2,080 postmenopausal women (age (mean +/- SD) 58.8 +/- 8.2 years), who were attending for routine check-up and in whom diseases and drug treatments known to affect bone metabolism had been excluded. Methods and outcome measures: Women underwent quantitative ultrasonometry (QUS) measurement at the heel. Values ​​of the ultrasonometry variables -speed of sound, broadband ultrasound attenuation and stiffness index -were calculated and compared for nulliparous and parous women and for women who had and had not breast-fed. Because of some significant intergroup differences, and to determine any effect of the number of live births and the duration of breast-feeding on ultrasonometry results, second analyzes were undertaken using equally sized samples, matched for possible confounding variables such as age and body mass index (matched pairs). In these analyzes, nulliparous women were compared with parous women, grouped according to number of live births, and women who had never breast-fed were compared with women who had breast-fed, grouped according to duration of breast-feeding. Furthermore, a multiple linear regression analysis was performed to examine the combined effects of reproductive factors on QUS variables. RESULTS: No statistically significant associations were found between ultrasonometry variables and parity or breast-feeding, even after controlling for confounding variables in matched pairs analysis or in a multiple linear regression analysis